Effectiveness of Endoscopic Treatment of Biliary Fistulas

Abstract

Abstract. Despite the great experience in biliary surgery, the total frequency of iatrogenic bile duct lesions, accompanied by the formation of biliary fistulas, reaches 2%.
 The aim of the study is to analyze the results of endoscopic treatment of patients with biliary fistulas after cholecystectomy.
 Materials and methods of research. The results of endoscopic treatment of 19 patients with biliary fistulas that occurred after cholecystectomy were studied. Women were 11 (57.9%), men – 8 (42.1%).
 Research results. The reason of the formation of bile fistula was biliary hypertension in case of choledocholithiasis in 14 (73.6%) patients. Endoscopic papillosphincterectomy was performed to restore the free passage of bile into the duodenum. Lithoextraction with balloon was carried out in 11 (57.9%) patients, and in 3 (15.8%) patients was used litoextraction with basket. Endobiliary drainage was performed in 5 (26.3%) patients. Conducting decompression of bile ducts in all cases of type A fistulas resulted in the cessation of bile fistula the day after surgery.
 Conclusions. ERCP is a highly effective method for treating biliary fistulas, which identifies the location of leakage of bile, and restoring of bile flowing to the duodenum helps to heal the fistula.